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杂合性缺失 1p/19q 与脑胶质瘤患者生存:一项荟萃分析。

Loss of heterozygosity 1p/19q and survival in glioma: a meta-analysis.

机构信息

Corresponding author: Jiaxin Zhao, MD, Department of Neurosurgery, the Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan Street, Nangang District, Harbin, Heilongjiang, China 150001.

出版信息

Neuro Oncol. 2014 Jan;16(1):103-12. doi: 10.1093/neuonc/not145. Epub 2013 Dec 4.

Abstract

BACKGROUND

Glioma is rarely curable, and factors that influence the prognosis of glioma patients are not fully understood. Loss of heterozygosity (LOH) of 1p/19q has long been known to be a typical molecular signature of oligodendroglial neoplasms. However, whether LOH of 1p/19q is associated with survival in gliomas remains controversial. Here our goal was to evaluate the association between LOH of 1p/19q and progression-free survival (PFS) and overall survival (OS) by conducting a meta-analysis among glioma cases.

METHODS

The PubMed and Embase databases were searched from the earliest records to May 2013 to identify studies that met prestated inclusion criteria. Reference lists of retrieved articles were also reviewed. Three authors independently extracted information needed for further analysis. Either a fixed- or a random-effects model was used to calculate the overall combined hazard ratio (HR) estimates.

RESULTS

Twenty-eight eligible studies involving 3 408 cases were included in the meta-analysis. Compared with the chromosomal intact group, codeletion of 1p and 19q was associated with a better PFS (HR = 0.63; 95% CI, 0.52-0.76) and OS (HR = 0.43; 95% CI, 0.35-0.53). Subgroup analyses showed this association to be independent of detection methods and the grades and subtypes of gliomas. Furthermore, isodeletion of chromosome 1p predicted a similar favorable disease outcome (PFS: HR = 0.68; 95% CI, 0.47-0.97) (OS: HR = 0.51; 95% CI, 0.35-0.75), especially in low-grade gliomas, whereas isodeletion of 19q only indicated longer PFS (HR = 0.70; 95% CI, 0.56-0.87).

CONCLUSION

Codeletion of 1p and 19q is associated with better survival rates in glioma. Isodeletion of 1p predicts similar outcomes but to a lesser extent, whereas the effects of isodeletion of 19q remained only marginal.

摘要

背景

胶质瘤很少能治愈,影响胶质瘤患者预后的因素尚不完全清楚。 1p/19q 的杂合性缺失 (LOH) 长期以来一直是少突胶质细胞瘤的典型分子特征。然而,LOH 1p/19q 是否与胶质瘤患者的生存相关仍存在争议。在这里,我们的目标是通过对胶质瘤病例进行荟萃分析,评估 LOH 1p/19q 与无进展生存期 (PFS) 和总生存期 (OS) 的相关性。

方法

从最早的记录到 2013 年 5 月,在 PubMed 和 Embase 数据库中检索符合既定纳入标准的研究。还对检索到的文章的参考文献进行了审查。三位作者独立提取进一步分析所需的信息。使用固定或随机效应模型计算总体合并危险比 (HR) 估计值。

结果

共有 28 项符合条件的研究纳入荟萃分析,共纳入 3408 例患者。与染色体完整组相比,1p 和 19q 缺失与更好的 PFS (HR = 0.63;95% CI,0.52-0.76) 和 OS (HR = 0.43;95% CI,0.35-0.53) 相关。亚组分析表明,这种相关性与检测方法以及胶质瘤的分级和亚型无关。此外,1p 染色体的等缺失预测类似的有利疾病结局 (PFS:HR = 0.68;95% CI,0.47-0.97)(OS:HR = 0.51;95% CI,0.35-0.75),特别是在低级别胶质瘤中,而 19q 的等缺失仅表明 PFS 更长 (HR = 0.70;95% CI,0.56-0.87)。

结论

1p 和 19q 的缺失与胶质瘤患者的生存率提高有关。1p 的等缺失预测类似的结果,但程度较小,而 19q 的等缺失的影响仍然只是边缘的。

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